10D2290273 CLIA NUMBER - TAMPA GENERAL HOSPITAL PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2290273
  • Facility Name: TAMPA GENERAL HOSPITAL PRIMARY CARE
  • Facility Address: 4620 PGA BLVD SUITE 101
    PALM BEACH GARDENS, FL
    ZIP 33418
  • Facility Phone: 561 559-0955
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURIE P. ROTHMAN
  • NPI Number: 1811679103
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2290273
LAB Type Physician Office
Facility Name TAMPA GENERAL HOSPITAL PRIMARY CARE
Street 4620 PGA BLVD SUITE 101
City PALM BEACH GARDENS
State FL
ZIP 33418
Phone 561 559-0955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Physician Office
Lab Director LAURIE P. ROTHMAN

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This page was last updated on: 9/29/2025